A Music Therapy Moment

Every music therapist has a wealth of stories about that exquisite musical/clinical moment when art and science come together to create an awareness, an accomplishment, a breakthrough. These stories – poignant, insightful, or humorous – show the power and effect of music therapy, and can help to build understanding of the benefits and applications of music therapy. These stories – along with the latest news and research in music therapy – bring the power of music therapy to people around the world, helping to educate and inspire and ensure access to quality music therapy services for every child, teen, and adult.

Take a moment now, and experience A Music Therapy Moment…

The Transformative Power of Working with People Who Are Facing Death

Our work as music therapists never stops giving us powerful experiences and lessons. This seems to be magnified when spending one’s days with people who are facing death. With this experience, music therapists are sensitized to the extreme emotions surrounding death, and can empathize with these patients and their families.

I had the privilege of working with an older man, who I’ll refer to as Mr. Smith, and who dearly touched my heart. Countless patients of mine have touched me, but Mr. Smith will remain in my memory as vividly as I saw him in the very hours we spent together.

At the end of life, there is a certain amount of one’s will that determines when one dies. I have seen people hold on to their lives with extreme pain and labored breathing, for weeks, just to reconcile a broken relationship with a loved one. That being said, there is simply no substitute for the beautiful and seamless opportunity that music therapy provides for people to complete their lives with dignity.

Music allowed Mr. Smith to die peacefully. The two songs that he specifically requested conveyed the messages he needed to share before departing from this world. Music therapy provided him the crucial opportunity or medium to express what he felt.

Since Mr. Smith was in a great deal of pain at the end of his life, we never engaged in very formal lyric analysis; however, Mr. Smith naturally expressed his analysis of these songs in small, intermittent statements during our sessions.

The first song he requested was Send In The Clowns, by Stephen Sondheim. This song, to Mr. Smith, highlighted the gross irony that, in stark contrast to the beauty and potential happiness in this world, there is often great emotional and physical pain in our final hours. The grand exit and culmination of our lives is often marked "not with a bang, but a whimper," as T.S. Elliot so poignantly writes. It is a cold reality; a cruel joke that often leaves us bitter. Send in the Clowns validated and beautifully conveyed feelings for Mr. Smith when he could not. He said "I used to be able to sing and dance, and now-" he paused and closed his eyes, wincing from a shooting pain- "well, I’m here in this place." "This place" was where people came to die. Mr. Smith knew that, because, in addition to being fully alert and oriented, he had a sister who had passed away there just two years before.

The second song he requested was "Try to Remember," from the Broadway musical The Fantastiks. This is a beautiful song that he particularly wanted his family to hear. There are several lines in this song that Mr. Smith highlighted by mouthing the words to his wife:

"Try to remember… and follow."

"Without a hurt the heart is hollow."

"Deep in December it’s nice to remember the fire of September that made us mellow."

I’ve wondered what Mr. Smith’s room would’ve been like without music therapy. Mr. & Mrs. Smith had four children- one who’d been estranged- all of whom were quite anxious. No one’s anxiety exceeded that of his wife, however. I was able to witness the facilitation of tears, hugs, and precious family interactions by our music therapy sessions together.

I’ve also wondered how my life would be without the experience and privilege of working with Mr. Smith. It is impossible to know for sure, but I can say that I am better able to keep an eye on the big picture of my life after working with him.

My time with Mr. Smith instilled in me a powerfully transformative thought. The music of our lives remains long after our bodies pass away; the love contained therein is eternal and will last beyond our pain.

Written by Sharon Graham, MM, MT-BC

The Gift of Music Therapy During My Daughter's Battle with Cancer

"When Allison would peek through the window of our hospital room door, guitar in hand, we would heave a sigh of relief and wave her in... Music has the power to transport the listener." Listen to this 3-minute testimonial from Jefri Franks, the mom of a child who received music therapy services throughout her fight with non-Hodgkin's lymphoma. Jefri shares highlights of music therapy helped her family find outlets and insights through their "harrowing journey."

Note: Current AMTA members can find a more detailed discussion of her family's experiences with music therapy in the AMTA-pro podcast series.

Music Therapists & Students On Music Therapy

This LiveReport from the Southwestern Regional Conference of the American Music Therapy Association was recorded in Amarillo, Texas in 2010. Listen to the .mp3 file to hear music therapists and music therapy students share their thoughts about their jobs, interventions, successes and efforts in their the profession of music therapy.

Music Hath Charms

Music has the power to charm the savage beast. It also has the power to enrich the mind of a child with autism. Many people with autism have limited verbal expression. They live a life of involuntary silence. "After silence, that which comes nearest to expressing the inexpressible is music." (Aldous Huxley) That is the reason why "music (became) the shorthand of (William's) emotions." (Leo Tolstoy) It gave him opportunities for speech, emotional contact and mental focus.

From the age of four through his current age of 16, William has taken a music bath once or twice a week at The Music Settlement. As Oliver Wendell Holmes once said, "...a music bath... is to the soul what the water bath is to the body." Music has flown out, immersing restless feelings, calming William, minimizing his hesitation. Then it ebbed and he met the eyes of the therapist. With the guidance of Ronna Kaplan and other music therapists, William has developed, encouraged to tune his fine and gross motor skills. The therapy program made use of live and recorded music, pre-planned dialogues for the clients and sound effects. While learning to play instruments, William also learned life skills. "Music (became the soundtrack of (his) life." (Dick Clark)

Being born with autism makes it difficult to interact with others or communicate verbally. It causes the affected person to be unaware of reacting in ways that others do not commonly react in society. Music therapy provided William a non-threatening environment in which to build relationships with peers, express himself verbally and nonverbally and learn to participate in socially acceptable ways. This was achieved through group therapy, as well as individualized sessions. Both forms were ideal for William, because individual lessons allowed him to learn at his own pace. These lessons were tailored to meet his needs. They helped him to learn to read music, follow a rhythm, and to respect the need to display the proper behavior in the proper situation. Small group therapy required him to learn to take turns and to be a focused member of a team. He had to use proper questions and verbal responses. He had to learn to be both leader and supportive member. This even carried over to life outside of The Music Settlement, as William auditioned for and earned a position on a regular team of drummers for his school. He was able to perform at the House of Blues in front of a large, noisy audience, with no problem. This was not something that he would have been able to withstand before his experiences in music therapy.

We are very pleased and thankful for the progress that William has made over the years and we foresee him continuing to flourish with additional music therapy. The combination of an excellent music therapy curriculum and an enthusiastic, care-giving staff, has enabled William not to just, "...go where a path might lead, but instead to go where there is no path and leave (his) trail." (Ralph Waldo Emerson)

I am closing with a short poem, expressing my feelings about The Music Settlement and its staff. It is simply entitled, Thank You.

Thank You

Music therapy teaches
Social skills.
It's about communication.
It's about what William's taught,
In nurturing situations.
He's learned patience
And tolerance,
Growing in many ways.
His social skills developed,
Made him what he is today.
So, thank you for your guidance,
As only music can touch.
Thank you for reaching our William,
Because it means so much.

Parent testimonial, written by Tamera Norris

used with permission

Reflections on the 10th Anniversary Meeting of the AMTA

I was deeply honored by the gracious invitation to attend this year’s annual meeting of The AMTA and receive the Advocate of the Year Award. At the meeting, I was impressed by the level of enthusiasm and dedication to excellence shown by the highly trained professionals I met. They radiated pride in their work coupled with an intense sense of fellowship which made me feel welcome and respected – even though I was a rookie. For this I am very grateful.

I learned the value of music therapy first-hand when I had a brain tumor diagnosed several years ago. Fortunately it was not a cancer, but my recovery from major cranial surgery was slow and difficult. I was given physical/occupational and speech therapy. The music therapist working with me on the burn unit knew I played piano by ear and she suggested I work out on the piano as part of my therapy. At first everything seemed strange and "nothing" worked. Molly wouldn’t let me quit. I wanted to – it was frustrating! Slowly I began the feel at home at the keyboard and all my other therapies started to become more effective. I could "think" better.

Music therapy forced my brain to respond to the complex patterns of pitch, tempo and melody, and forced me to integrate motor function with the psycho-acoustic properties of what I was trying to express. I promptly regained my surgical skills at my pre-operative level and returned to practice on the burn unit. This response is known as neuro-plasticity; the unique ability of the brain to bypass injured areas and to re-teach the damaged brain how to regain more normal function.

I believe music therapists play an important, but often overlooked, role in helping patients cope with the effects of illness, pain, loneliness and fearful apprehension about the future of their health. Unfortunately all too often, music therapy is not reimbursed by insurance companies and many hospitals, therefore, do not use this modality of patient care. Other traditional forms of therapy, i.e. physical/occupational/speech etc., have demonstrated they are a cost effective addition to patient recovery. Insurance companies are therefore willing to compensate hospitals for these services and they generate income for the medical facility.

Music therapy professionals MUST produce evidence that their services provide a cost effective addition to other forms of care. THAT MEANS GOOD SCIENTIFIC RESEARCH must be carried out to demonstrate what we all believe. It is not enough to show a reduction in pain and anxiety with music therapy. Research must show a reduction in length of stay or improved patient outcomes for patients such as those sustaining head trauma/post traumatic stress disorder etc. Only then will insurance companies agree to reimburse hospitals/nursing homes for music therapy services; and more medical facilities will be able to incorporate music therapy as a standard of care. Then patients will receive the services we all know will benefit them. May God Speed your efforts on behalf of the patients you serve.

The Knot at the End of the Rope

My father lived life with strength and determination. As complications associated with diabetes diminished his physical capabilities, his indomitable will to combat the disease fervently hammered away. A WW II Navy Seal, Joe Altman lived by a simple rule; when you get to the end of your rope, tie a knot and hang on.

When dementia struck hard and violently broke through Dad’s spirit, music therapist Alessandro Ricciarelli entered his life. Armed with six strings attached to a wooden guitar, Alessandro surpassed the capabilities of the most sophisticated medical technology.

Each time Alessandro walked through the door, an invisible wall formed around them, creating a comfortable space in which a trusting bond of friendship would quickly form. Alessandro brought with him happiness, encouragement, added a sense of meaning and purpose to Dad’s life, and, in doing so, resuscitated his spirit. In a most gentle way, Alessandro treated Joe with the utmost dignity and respect.

Alessandro’s dedication was not limited to actual hospital visits; he took personal time to learn songs that were relevant to Dad and made recordings of their sessions together to be enjoyed at any given time. Alessandro appreciated the power of positive thoughts, and with his kind words, a smile, compassion, and a true desire to make Dad happy, he encouraged Dad’s participation, leaving us with cherished memories of my father having one last chance to express himself through music, smiling and enjoying life.

In a very real sense, Alessandro was that knot at the end of the rope on to which Dad grabbed. I am forever grateful to the Music Therapy Program at NYU Medical Center, more specifically, to Mr. Alessandro Ricciarelli.

Everyone knows that labor and delivery can be a painful and sometimes anxiety producing experience for the mother, the coach, and even the hospital staff. Music therapists can help reduce these negative aspects of childbirth by providing music therapy before, during, and even sometimes, after the birth of a child. The following summary is evidence of the positive effects of Music Therapy Assisted Childbirth.

In 1983, Hanser, Larson, and O’Connell studied the use of music to enhance relaxation and decrease pain responses in mothers during childbirth. The music therapists used music to cue rhythmic breathing, assist the mothers in relaxation, prompt positive associations, and help focus attention on the music as a diversion from pain and hospital sounds. A small sample of seven Lamaze-trained mothers was used and subjects served as their own controls. Two individual music therapy sessions were conducted with the subjects prior to the birth experiences. In the first session the music therapist established rapport and determined the musical preferences of the mother. Prior to the second session the music therapist developed an individualized music program for each mom. During the second session the mothers were familiarized with their music programs and instructed in relaxation and breathing techniques.

The music therapists attended the births and monitored music during the experience. During labor each mother experienced periods of music and non-music and were observed under both conditions. Observations of tension and relaxation in various parts of the body were made and recorded. Two other relaxation behaviors, breathing and verbalization were observed and recorded as positive, negative, or neutral. During the delivery phase the music therapists played music that was specially selected by each mother and her coach.

One week after the delivery each mother was given a post-delivery questionnaire and was asked how the music helped her concentrate, relax, and whether it helped with rhythmic breathing. Results indicated that all of the mothers had fewer pain responses in the music vs. no-music condition, and that music aided concentration, relaxation, cued breathing, and diverted attention from pain.

Coaches and hospital staff also responded well to the music, indicating that the music made a positive contribution to the labor and delivery experience.

Submitted by Mary DiCamillo, Ed.D., MT-BC. Mary DiCamillo, Ed.D, MT-BC, is a Pre- and Peri-Natal Music Therapist/Doula at The Sound Birthing Program in Rancho Santa Margarita, California.This summary is based on the following article published in the Journal of Music Therapy, which is the research journal of the American Music Therapy Association.Hanser, S., Larson, S.C. & O’Connell, A.S. (1983). The effect of music on relaxation of expectant mothers during labor. Journal of Music Therapy, 20 (2), 50-58.

Research Findings Show Effectiveness of Music Therapy Assisted Childbirth

The field of Music Therapy Assisted Childbirth has been growing and developing during the last twenty years. A landmark study by Clark, McCorkle, and Williams (1981) was the first published treatment protocol for music therapists for working with labor and delivery patients. Their investigation was a preliminary study of the effectiveness of music for pain relief during labor and delivery. They found that music serves several functions in the natural childbirth process including attention focusing, distraction from pain, stimulating pleasure responses, focusing breathing, and as a conditioned stimulus for relaxation.

There were 20 subjects in this study. Thirteen experimental subjects received 6 pre-natal music training sessions with a music therapist. Seven control group subjects did not receive the music treatment. The treatment sessions were focused on selecting appropriate music and learning/practicing music-assisted relaxation techniques. The experimental group patients each received a stereo cassette tape for home practice in order to become familiar with the relaxation techniques. The Music Therapist was notified when each subject went to the hospital and assisted the patients in labor and delivery. The therapist played the music continually and relied on it more than verbal contact when the woman was in labor. During the pushing phase, the tempo, intensity, and energy of the music were increased to give the mothers energy to push. Special music, which was chosen by the parents, was played at the time of the delivery and the music concluded when the patient left the delivery room. After the birth, the music therapist administered a childbirth experience questionnaire to each subject.

Results indicated that the music group had higher success scores on 5 out of 7 indices of the childbirth process. A moderate correlation between home practice with the music and successful outcome was also found. The authors also noted the possibility that perhaps support from a music therapist during labor and delivery contributed to successful outcome. Overall, findings suggested that music therapy may successfully contribute to reducing anxiety during childbirth, as well as augment positive feelings of support throughout the childbirth experience.

Submitted by Mary DiCamillo, Ed.D., MT-BC. Mary DiCamillo, Ed.D., MT-BC, is a Pre and Peri-Natal Music Therapist/Doula at The Sound Birthing Program, Rancho Santa Margarita, California. This summary is based on the following article from the Journal of Music Therapy, which is a research journal published by the American Music Therapy Association.Clark, M.E. McCorkle, R. R. & Williams, S. B. (1981). Music therapy assisted labor and delivery. Journal of Music Therapy, 28 (2), 88-100.

Music Therapy in Alzheimer’s Disease

Rose is in her eighties and lives in a nursing home due to her diagnosis of Probable SDAT - Senile Dementia of the Alzheimer Type. She speaks in one-word syllables, appears unaware of her surroundings and cannot take care of her bodily needs. However, when she is visited by the music therapist and sings "You are my Sunshine," her words are clearly understood. Her singing has recognizable pitch and melody, and she sings with emotional expression. Her face brightens, and she makes eye contact with the therapist. Rose also enjoys participating in group music therapy. The members of her drum circle group have learned how to start and stop together, to change their playing from loud to soft and to play a variety of rhythmic patterns. They stay seated and pay attention to the therapist’s directions for the entire thirty-minute session. The nursing staff on the unit has noticed that for several hours following the group, those who have participated seem to have a better mood, are less agitated and more relaxed.

A diagnosis of "Alzheimer’s Disease" strikes fear and sadness into a family’s heart. There is no cure, and the care of a person with Alzheimer’s Disease can mean heavy financial and psychological burdens for family members. It is important that families facing this situation be aware that there are many sources of help and support. One important source of help can be music therapy. Research studies have shown that people with Alzheimer’s Disease respond to music at all stages of the disease. For example, in the early stages of the disease, the music therapist can help the person use existing music skills to constructively fill his or her leisure time. Music also can be paired with relaxation techniques to relieve symptoms of depression. During the middle stages of the disease, listening to and talking about familiar music can provide a source of comfort and reassurance. Theme-based music therapy groups can challenge cognitive skills, encourage social interaction and improve mood. Even people in the later stages of dementia can benefit from involvement with music. At this stage, music can encourage communication through eye contact, touch and changes in facial expression. Favorite recorded music also can be helpful in decreasing problem behaviors associated with agitation or aggression, and singing with or to a person can provide meaningful human contact.

Why a music therapist? Won’t the radio, TV or CD player accomplish the same goals? The music therapist’s specialized training enables him or her to choose and adapt music experiences that match the individual’s interests, needs and abilities. At every stage of Alzheimer’s Disease, there is a greater chance of success when a music therapist is present to structure the experience and to offer encouragement. Carefully chosen music experiences plus the nurturing contact with the therapist can draw the person with dementia out of a world of isolation into a world of comfort and connection. For the individual with Alzheimer’s Disease, music therapy can be a gift that helps to reveal hidden sources of creativity, and to restore a sense of their personhood.

Submitted by Anne Lipe, Ph.D., MT-BC Anne Lipe, Ph.D., MT-BC has been serving older adults as a music therapist for twenty years. Her major research interest is how music tasks can be used to evaluate cognitive ability in people with Alzheimer's Disease.

Music Cognition in People with Alzheimer's Disease

What can singing a familiar song or playing different rhythms on a hand drum tell us about thinking abilities in someone with Alzheimer’s Disease?

When someone is suspected of having Alzheimer’s Disease or a related dementia, several evaluations are conducted by a medical team. These evaluations may include physical and psychological examinations, and tests of the person’s memory and thinking ability. These mental status tests provide information about awareness of person, place and time; the ability to identify and recall objects, to perform simple calculations and spelling tasks, and to follow written instructions. Older people who are having difficulty with their memory and thinking skills may feel anxious in testing situations. Their concern about coming up with the right answers may even get in the way of their ability to do well on the test. Can music help us to get this information in a way that makes things easier on the person being tested?

In a recent study, thirty-two older adults performed a variety of singing and rhythm playing tasks under the direction of a music therapist. Both new and familiar songs were sung, and questions were asked about the songs. Study participants were introduced to a hand drum, and were asked to imitate rhythms played by the therapist, to chant and play rhythms at the same time, and to make up their own rhythm patterns. Participants also received three mental status tests typically used to evaluate people who have symptoms of a dementia-related illness.

Results of this study found that the ability to do the tasks on the music evaluation was not influenced by prior music training. Results also found strong relationships between participants’ scores on the standard mental status tests and the music evaluation. This shows that the two types of tests are likely to be measuring similar kinds of thinking ability. Specific music skills were associated with each stage of dementia. For example, people in later stages of dementia could not sing, but could imitate rhythm patterns on the hand drum.

Several practical implications can be drawn from this study. All of the participants in the study were able to complete all of the tasks. Even those with severe dementia paid attention to the therapist during the entire evaluation, and responded in some way to the tasks. Many of the tasks on the music evaluation did not require a spoken response. This is important, because as a dementia progresses, people lose the ability to communicate verbally. Music offers a way to communicate that doesn’t depend on spoken language.

Did the music-making experience make the testing situation more enjoyable for the people in this study? Perhaps. What this study does show is that music can help to reveal cognitive and creative abilities that lie hidden beneath the cloud of a dementia-related illness.

This summary is based on the following article by Anne Lipe, Ph.D., MT-BC, published in the Journal of Music Therapy: Lipe, A. (1995). The use of music performance tasks in the assessment of cognitive functioning among older adults with dementia. Journal of Music Therapy, 32(3), 137-151.

Submitted by Anne Lipe, Ph.D., MT-BC Anne Lipe, Ph.D., MT-BC, has been serving older adults as a music therapist for twenty years. Her major research interest is how music tasks can be used to evaluate cognitive ability in people with Alzheimer's Disease.

How can you help support music therapy?

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